Clinical InvestigationTwo-Dimensional Speckle Strain and Dyssynchrony in Single Right Ventricles Versus Normal Right Ventricles
Section snippets
Study Population
Patients with single morphologic RV physiology who underwent Fontan or Kawashima palliation were recruited. Patients who had cardiac hospitalizations, cardiac surgery, or cardiac catheterization procedures within the past 3 months were excluded. Patients undergoing long-term pacing were also excluded. This cohort therefore consisted of single-RV patients who were cardiovascularly stable. Age-matched control subjects were recruited and prospectively identified by echocardiography to be normal.
Demographics
Fourteen patients with single RVs who underwent Fontan or Kawashima palliation and 16 age-matched control children, who were clinically stable, were consented for the study. One patient with hypoplastic left-heart syndrome and 3 control patients were excluded because of poor tracking, so this study consisted of 13 patients in each group. Excluded patients did not differ significantly from control patients. There was no significant difference in age or weight between groups (Table 1). Clinic
Discussion
In most instances, right ventricular function is described qualitatively because quantification of the systolic function of the RV is difficult to assess because of its unique geometry.5 Quantification of the RV is especially important in those patients with single-RV physiology because their prognosis is markedly different compared with the general population, and the earlier detection of abnormal right ventricular function may aid in treatment options.4, 15, 16 Strain and strain rate are
Conclusion
In this study, children who underwent Fontan palliation were shown to have decreased strain, strain rate, and longitudinal displacement and increased dyssynchrony of the single RV at a relatively young age. The implications of the increased dyssynchrony remain to be determined, but these results may serve as a platform for longitudinal studies to correlate these findings with clinical symptoms to determine if these echocardiographic findings can predict and eventually aid in managing this
Acknowledgment
We would like to thank Pierre Miller, RDCS, RVT, at GE Healthcare for applications support and Dave Melvin, CRT for illustration formatting.
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